Hayes Alexander M L
Medical Sciences Division, Faculty of Clinical Medicine, University of Oxford, Oxford, United Kingdom.
South Afr J HIV Med. 2020 Aug 12;21(1):1089. doi: 10.4102/sajhivmed.v21i1.1089. eCollection 2020.
While combined antiretroviral therapy (cART) allows near-normal life expectancy for people living with human immunodeficiency virus (HIV), it is unable to cure the infection and so life long treatment is required.
The main barrier to curing HIV is the latent reservoir of cells, which is stable and resistant to cART.
Current approaches under investigation for clearing this reservoir propose a 'Shock and Kill' mechanism, in which active replication is induced in latent cells by latency reversal agents, theoretically allowing killing of the newly active cells.
However, previous studies have failed to achieve depletion of the central memory cell reservoir, are unable to target other latent reservoirs and may be causing neurological damage to participants.
Future approaches to clearing the latent reservoir may bypass latency reversal through the use of drugs that selectively induce apoptosis in infected cells. Several classes of these pro-apoptotic drugs have shown promise in and studies, and may represent the basis of a future functional cure for HIV.
虽然联合抗逆转录病毒疗法（cART）能让人类免疫缺陷病毒（HIV）感染者的预期寿命接近正常水平，但该疗法无法治愈感染，因此需要终身治疗。
治愈HIV的主要障碍是潜伏细胞库，其稳定且对cART有抗性。
目前正在研究的清除该细胞库的方法提出了一种“激活并杀死”机制，即通过潜伏期逆转剂在潜伏细胞中诱导活跃复制，理论上可杀死新激活的细胞。
然而，先前的研究未能实现清除中央记忆细胞库，无法靶向其他潜伏细胞库，且可能对参与者造成神经损伤。
未来清除潜伏细胞库的方法可能通过使用能选择性诱导感染细胞凋亡的药物来绕过潜伏期逆转。几类这类促凋亡药物已在[具体研究]和[具体研究]中显示出前景，可能代表未来HIV功能性治愈的基础。
